XIX Meeting of the PAHO Directing Council. XXI Meeting of the WHO Regional Committee for the Americas FINAL REPORT

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1 XIX Meeting of the PAHO Directing Council XXI Meeting of the WHO Regional Committee for the Americas FINAL REPORT

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3 El texto en espafiol aparece en las páginas 1-43 CONTENTS Page PREAMBLE RESOLUTIONS I. Review of the Rules of Procedure of the Governing Bodies of the Pan American Health Organization II. Annual Report of the Chairman of the Executive Committee 53 III. Application on Article 6-B of the PAHO Constitution IV. Collection of Quota Contributions V. Financial Report of the Director and Report of the External Auditor for VI. VII. VIII. Annual Report of the Director of the Pan American Sanitary Bureau for Appropriations for the Pan American Health Organization for Objectives, Functions, and Financing of the Institute of Nutrition of Central America and Panama IX. Nutrition Program in the Americas X. Use of the Resources of the World Food Program for Health Programs, Preliminary Report XI. Emergency Situation in Honduras and El Salvador XII. Laboratory Colonies of A edes aegypti XIII. XIV. XV. XVI. Provisional Draft of the Proposed Program and Budget Estimates of the Pan American Health Organization for Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for Election of Three Member Governments to the Executive Committee on the Termination of the Periods of Office of Brazil, Colombia, and the United States of America Assessments of the Member Governments and Participating Governments of the Pan American Health Organization XVII. Malaria Eradication XVIII. Report of the Study Group on the Coordination of Medical Care Services of Ministries of Health, Social Security Institutes, and Universities

4 CONTENTS (cont.) Page XIX. PAHO Regional Library of Medicine XX. XXI. Brazilian Plan for the Coordination of Activities Relating to the Protection and Recovery of Health Amendments to the Staff Rules of the Pan American Sanitary Bureau XXII. Salary of the Director of the Pan American Sanitary Bureau XXIII. Aedes aegypti XXIV. Fluoridation of Public Water Supplies XXV. XXVI. Study of the Preparation of Drugs and Biological Products, Production and Maintenance of Equipment and Instruments for Health Programs Strengthening of the Process of Program and Project Evaluation XXVII. Long-Term Planning and Evaluation XXVIII. Health Legislation XXIX. Buildings and Installations XXX. Resolutions of the Twenty-Second World Health Assembly of Interest to the Regional Committee XXXI. Smallpox Eradication XXXII. Selection of the Topic for the Technical Discussion during the XVIII Pan American Sanitary Conference, XXII Meeting of the Regional Committee of WHO for the Americas XXXIII. Special Fund for Health Promotion XXXIV. Control of Cigarette Smoking XXXV. Medical Education XXXVI. Financing of the Textbook Program, Pan American Health and Education Foundation XXXVII. Multinational Centers XXXVIII. Within-Country Fellowships XXXIX. Technical Discussions on the Topic "Financing of the Health Sector" ANNEX: Participants

5 FINAL REPORT The XIX Meeting of the Directing Council of the Pan American Health Organization, XXI Meeting of the Regional Committee of the World Health Organization, was held in the Headquarters building in Washington, D. C., from 29 September to 10 October 1969, as convoked by the Director of the Pan American Sanitary Bureau pursuant to Resolution II adopted by the Executive Committee at' its 61st Meeting. PARTICIPANTS 1 The meeting was opened by the President of the XVIII Meeting of the Directing Council, XX Meeting of the Regional Committee of the World Health Organization, Dr. Ezequiel Alberto Dago Holmberg, Secretary of State for Public Health of the Republic of Argentina. The following Governments were represented: Argentina, Barbados, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, France, Guatemala, Guyana, Haiti, Honduras, Jamaica, Kingdom of the Netherlands, Mexico, Nicaragua, Panama, Peru, Trinidad and Tobago, United Kingdom, United States of America, Uruguay, and Venezuela. The Government of Canada designated an official observer. The meeting was also attended by Dr. A. M.-M. Payne, Assistant Director- General of the World Health Organization, as well as by observers from the Organization of American States (OAS), the Inter-American Development Bank (IDB), the United Nations, the Food and Agriculture Organization of the United Nations (FAO), the United Nations Children's Fund (UNICEF), and the United Nations Development Program (UNDP). Observers from 10 nongovernmental organizations were also present. INAUGURAL SESSION The inaugural session was held on 29 September 1969 in the Council Chamber of the Headquarters building. It was attended by representatives of the various countries participating in the meeting, by members of the Diplomatic Corps, and by representatives of international agencies and nongovernmental organizations. Addresses were delivered by Dr. Ezequiel Alberto Dago Holmberg, President of the XVIII Meeting of the Council; by Mr. Galo Plaza, Secretary General of the Organization of American States; by Dr. A. M.-M. Payne, Assistant Director-General of the World Health Organization; and by Dr. Abraham Horwitz, Director of the Pan American Sanitary Bureau. 'The complete list of participants appears in the annex, p

6 OFFICERS The President, the two Vice-Presidents, and the Rapporteur were elected pursuant to Rule 18 of the Rules of Procedure. The officers were as follows: President: Vice-Presidents: Rapporteur.' Secretary ex officio: Dr. Sylvia Talbot Dr. Murillo B. Belchior Dr. Arnoldo Fernández Soto Dr. Rogelio Valladares Dr. Abraham Horwitz Guyana Brazil Costa Rica Venezuela Director, Pan American Sanitary Bureau COMMITTEE ON CREDENTIALS The Committee on Credentials, established pursuant to Rule 25 of the Rules of Procedure, was composed of the following members: Chairman: Rapporteur: Member: Dr. Mario Antonio Femández Mena Dr. Luis F. Gómez-Lince Dr. Aníbal Grimaldo Carles Dominican Republic Ecuador Panama GENERAL COMMITTEE The Representatives of Mexico, Peru, and the United States of America were elected to the General Committee, which, pursuant to Rule 26 of the Rules of Procedure, was composed as follows: Dr. Sylvia Talbot President of the Council Dr. Murillo B. Belchior Vice-President of the Council Dr. Arnoldo Fernández Soto Vice-President of the Council Dr. Rogelio Valladares Rapporteur of the Council Dr. Pedro Daniel Martinez Representative Dr. David Tejada-de-Rivero Representative Dr. S. Paul Ehrlich, Jr. Alternate Representative Guyana Brazil Costa Rica Venezuela Mexico Peru United States of America 50

7 AGENDA Pursuant to Rule 10 of the Rules of Procedure, the Directing Council adopted at its second plenary session the provisional agenda (Document CD19/1, Rev. 2)2 submitted by the Director and, in so doing, included two additional items entitled "Brazilian Plan for the Coordination of Activities Relating to the Protection and Recovery of Health," which was proposed by the Representative of Brazil, and "Emergency Situation in Honduras and El Salvador," which was proposed by the Director. In accordance with Rule 11 of the Rules of Procedure, the Directing Council approved at its fourteenth plenary session the addition of an item entitled "Control of Cigarette Smoking," which was proposed by the Representative of Colombia. WORKING PARTIES Three working parties were established. The first was entrusted with reviewing the suggested subjects for the Technical Discussions to be held during the XVIII Pan American Sanitary Conference, XXII Meeting of the Regional Committee of WHO for the Americas, and preparing a list of not more than three subjects for submission to the plenary meeting. It was composed of the Representatives of Guatemala, Jamaica, and Venezuela. The second working party, appointed to prepare a draft resolution on Item 22 (Aedes aegypti Eradication), was composed of the Representatives of Jamaica, Mexico, the United States of America, and Venezuela. The third working party was entrusted with the preparation of a draft resolution on Item 20 (Proposed Criteria for Multinational Centers) and was composed of the Representatives of Argentina, Peru, the United States of America, and the Rapporteur. The working parties presented the reports and draft resolutions in plenary sessions. TECHNICAL DISCUSSIONS The topic of the Technical Discussions of the Directing Council, which were held on 7 October 1969, was "Financing of the Health Sector." The officers were as follows: Moderator: Dr. Luis Carlos Ochoa Ochoa Rapporteur: Dr. David Tejada-de-Rivero Technical Secretary: Dr. Alfredo Arreaza Guzmán Colombia Peru Assistant Director, Pan American Sanitary Bureau 2 See Oficial Document PAHO

8 Moderator: Dr. Luis F. Gómez-Lince Rapporteur: Dr. Alberto Aguilar Rivas Technical Secretary: Dr. Juan José Barrenechea Working Party I Ecuador El Salvador Health Planning Section, Pan American Sanitary Bureau Moderator: Dr. Ignacio Avila Cisneros Rapporteur: Dr. Héctor Trajano Arias Albán Technical Secretary: Dr. José Luis García Gutiérrez Working Party II Mexico Venezuela Department of Special Technical Services, Pan American Sanitary Bureau The panel members appointed by the Pan American Sanitary Bureau were as follows: Mrs. Lucila Leal de Araújo Dr. Juan José Barrenechea The report of the Technical Discussions was submitted to the seventeenth plenary session, which adopted a resolution on it. SESSIONS The Directing Council held an inaugural session, seventeen plenary sessions, and a closing session; the Committee on Credentials held five sessions; and the General Committee eight sessions. RESOLUTIONS APPROVED In the course of the meeting, the Directing Council approved the following resolutions: 52

9 Resolution I Review of the Rules of Procedure of the Governing Bodies of the Pan American Health Organization Having considered the report of the Director (Document CD19/13) 3 prepared in implementation of Resolution XV 4 of the XVIII Meeting of the Directing Council; Taking into consideration that similar changes have already been introduced into the Rules of Procedure of the Executive Committee; Bearing in mind the recommendation adopted in Resolution I s of the 61st Meeting of the Executive Committee; and Bearing in mind the provisions of Rule 58 of the Rules of Procedure of the Directing Council and Rule 61 of the Rules of Procedure of the Conference, 1. To approve the changes in the Rules of Procedure of the Directing Council as they appear in Document CE61/11 (Annex II), with Rule 23 as amended during the consideration of the document. 2. To transmit to the XVIII Pan American Sanitary Conference Document CE61/11 and to recommend its favorable consideration of the proposed changes in the Rules of Procedure of the Conference (Annex III), with Rules 1 and 37 as amended during the consideration of the document. (Approved at the second plenary session, 29 September 1969) Resolution II Annual Report of the Chairman of the Executive Committee Having reviewed the Annual Report of the Chairman of the Executive Committee, Dr. Orontes Avilés, Representative of Nicaragua (Document CD19/20 and Addendum I),6 on the work of that Governing Body during the period that has elapsed since the XVIII Meeting of the Directing Council; and Bearing in mind the provisions of Article 9-C of the Constitution of the Pan American Health Organization, 3 Mimeographed document. 40fficial Document PAHO 93, Official Document PAHO 96, 7. 6 See Official Document PAHO

10 To approve the Report of the Chairman of the Executive Committee, Dr. Orontes Avilés, Representative of Nicaragua (Document CD19/20 and Addendum I), and to commend him and the othér members of the Committee on the work accomplished. (Approved at the fourth plenary session, 30 September 1969) Resolution III Application of Article 6-B of the PAHO Constitution Noting that four Governments have quotas in arrears more than two years and are thus subject to Article 6-B of the PAHO Constitution, and that three of those Governments have sent representatives to the XIX Meeting of the Directing Council; and Having examined the efforts made by those Governments to meet their obligations, To permit Bolivia, the Dominican Republic, and Haiti to vote in this XIX Meeting of the Directing Council. (Approved at the fourth plenary session, 30 September 1969) Resolution IV Collection of Quota Contributions Having considered the report on the collection of quota contributions (Document CD19/6 and Addenda 1 and II),7 as well as the information and comments on quotas contained in the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91); 7 Mimeographed document. 54

11 Noting with satisfaction that, as a percentage, the total amount in arrears more than one year is the lowest in the last ten years, but noting with concem that the number of countries in arrears more than two years has not diminished; and Considering the importance of obtaining the full support of all Governments for the program of the Organization through prompt and full payment of quota contributions, 1. To take note of the report on the collection of quota contributions (Document CD19/6 and Addenda I and II) and of the information and comments on quotas contained in the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91). 2. To thank the Governments and the Director for the success achieved in reducing arrears to the lowest level in many years. 3. To express concern about the number of Governments in arrears more than two years and to recommend to those Governments that they fulfill their financial plans for the payment of arrears within a definite period. 4. To request the Director to continue to inform the Governments of the status of quota collections and to bring to their attention the importance of unanimous support of the program of the Organization through the full and prompt payment of quota contributions by each Member Government. Resolution V (Approved at the sixth plenary session, 1 October 1969) Financial Report of the Director and Report of the External Auditor for 1968 Having examined the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91); Noting with satisfaction that the Organization continues to be in sound financial condition, as shown by the fact that the total amount of quotas in arrears more than one year is the lowest in many years and that the level of the Working Capital Fund and the reserve for termination costs were both increased; and Observing that the External Auditor, in accordance with the provisions of Article 12.6 of the PAHO Financial Regulations, has made positive comments with respect to the efficiency of the administrative, financial, and accounting procedures and controls, 55

12 1. To approve the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91). 2. To commend the Director on having placed and maintained the Organization's finances in sound condition through the consistent application of the policies for maintaining budgetary expenditures within income and building up the Working Capital Fund and the reserves for termination costs. 3. To thank the External Auditor for including in his Report the necessary and appropriate observations with respect to the efficiency of the administrative, financial, and accounting procedures and controls. (Approved at the seventh plenary session, 2 October 1969) Resolution VI Annual Report of the Director of the Pan American Sanitary Bureau for 1968 Having considered the 1968 Annual Report of the Director of the Pan American Sanitary Bureau, Regional Office of the World Health Organization for the Americas (Official Document 95); Bearing in mind the statements of the representatives emphasizing the valuable support given by the Pan American Health Organization to the efforts of the countries to raise the level of health of the population; Bearing in mind also the concern expressed by the representatives about the persistence of problems of sanitation, communicable diseases, and nutrition and the complexity of the situation in the Region, where the health services in the countries have achieved different levels of development; and Taking into account the provisions of Article 4-F of the Constitution of the Pan American Health Organization, 1. To approve the Annual Report of the Director of the Pan American Sanitary Bureau for 1968 (Official Document 95), and to commend him and his staff on the excellent work done during the year. 2. To recommend to the Member Governments that they make a careful review of the health situation in their countries so as to determine the priority areas in which the work of the Pan American Sanitary Bureau can be most effective. 56

13 3. To recommend to the Member Governments that they regard the Annual Reports of the Director of the Pan American Sanitary Bureau as working documents of regional importance, indicating where the interests and efforts of each country fit into the welfare of the countries of the Americas as a whole. (Approved at the seventh plenary session, 2 October 1969) Resolution VII Appropriations for the Pan American Health Organization for 1970 The Directing Council 1. To appropriate for the financial year 1970 an amount of $15,475,578 as follows: Part I: Organizational Meetings. Part II: Headquarters. Part III: Field and Other Programs... Part IV: Special Fund for Health Promotion... Part V: Increase to Assets. Subtotal-Parts I-V... Part VI: Pan American Foot-and-Mouth Disease Center... Effective Working Budget (Parts I-VI)... Part VII: Staff Assessment (Transfer to Tax Equalization Fund)... Total-All Parts... $ 334,205 3,192,260 8,604, , ,000 $12,531,403 1,320,716 $13,852,119 1,623,459 $15,475, That the appropriation shall be financed from: a) Assessments in respect to: Member Governments and Participating Governments assessed under the scale adopted by the Council of the Organization of American States in accordance with Article 60 of the Pan American Sanitary Code or in accordance with Directing Council resolutions... $15,270,578 b) Miscellaneous Income ,000 Total... $15,475,578 In establishing the contributions of individual Governments and Participating Governments, their assessments shall be reduced further by the amount standing 57

14 to their credit in the Tax Equalization Fund, except that credits of those Governments who levy taxes on the emoluments received from PAHO by their nationals and residents shall be reduced by the amounts of such tax reimbursements by the Organization. 3. That, in accordance with the Financial Regulations of the Organization, amounts not exceeding the appropriation noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January to 31 December 1970, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial year 1970 shall be limited to the effective working budget, i.e., Parts 1-VI. 4. That the Director shall be authorized to transfer credits between parts of the effective working budget, provided that such transfers of credits between parts as are made do not exceed 10 per cent of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10 per cent of the part from which the credit is transferred may be made with the concurrence of the Executive Committee. All transfers of budget credits shall be reported to the Directing Council. (Approved at the tenth plenary session, 3 October 1969) Resolution VIII Objectives, Functions, and Financing of the Institute of Nutrition of Central America and Panama 8 Recognizing that nutrition has a high priority in national health services in the Hemisphere; Seeing that there is a gradual increase in the demarid for improved health, in particular for specialized training and consultation services in nutrition, as well as for applied research in this field; Considering that over the years the Institute of Nutrition of Central America and Panama (INCAP) has gained excellent experience in providing needed nutrition services both in Central America and in the rest of the Hemisphere; and Acknowledging that the needs of INCAP must be considered within the over-all nutrition program of the Americas and the total resources available to support that program, 1. To recommend to the Director that he provide INCAP with assistance in 8 For reference Document CD19/22 and Appendices, see OfficialDocumentPAHO

15 reorienting its present programs in order to better meet the needs of present Members of the Institute and the remaining countries of the Hemisphere. 2. To recommend that the Director continue to seek funds for INCAP from its traditional sources and increase, to the extent the budget of the Organization so permits, the annual grant which is made to the Institute to enable it to effectively carry out the proposed expansion of its services. 3. To recommend that the INCAP program and budget be adjusted to coincide with estimated resources. (Approved at the tenth plenary session, 3 October 1969) Resolution IX Nutrition Program in the Americas 9 Considering that human malnutrition continues to be a major problem of health and welfare for many populations of this Hemisphere; and Considering that present demographic and food production trends indicate that this problem might become more serious in the future, 1. To recommend to the Pan American Sanitary Bureau that it continue to give high priority to this program and that it assign corresponding resources to provide the services required for effective action, especially in the formulation of national food and nutrition policies. 2. To recommend to the Member Governments that national food and nutrition policies be formulated according to suggested guidelines as soon as possible with the objective of controlling the problem of malnutrition, thus reducing the costs of health care and allowing reassignment and more efficient use of resources. (Approved at the tenth plenary session, 3 October 1969) 9 For reference Document CD19/9 and Appendices, see Official Document PAHO

16 Resolution X Use of the Resources of the World Food Program for Health Programs, Preliminary Report Having considered the preliminary report of the Director on the use of resources of the World Food Program for health programs (Document CD19/17);1 Bearing in mind the level of the present contribution of the Program to the health sector and the possibility that this contribution may be substantially increased; Considering that, if good results are to be obtained from this Program the conditions for operating it in each country must be advantageous; Taking into account the possible effects that the supply of food under the World Food Program may have on the development of national and regional agricultural and industrial programs; and Bearing in mind the recommendation of the 61st Meeting of the Executive Committee, To take note of the preliminary report of the Director on the use of the resources of the World Food Program for health programs, and to express its interest in the possibilities set forth in that document. 2. To recommend to the Director that he continue to encourage the use of the resources of the World Food Program, periodically informing the Governments and providing those Governments that request it with assistance in preparing applications for aid from the Program. 3. To recommend to the Governments that they study the availability of the transportation, food storage, and food distribution facilities necessary for operating the Program. 4. To recommend to the Governments that, in studying the possible effects of the World Food Program on national plans for the production and marketing of foodstuffs, due priority be given to the food needs of the population. (Approved at the tenth plenary session, 3 October 1969) 10 See Official Document PAHO Resolution XXII. Official Document PAHO 96,

17 Resolution XI Emergency Situation in Honduras and El Salvador' Having considered Document CD19/25 and Addendum' 2 on the Inter- American Emergency Aid Fund and the emergency situation in Honduras and El Salvador; Bearing in mind the action taken by.the Secretary General of the Organization of American States and by the Director of the Pan American Sanitary Bureau in this situation; and Bearing in mind the statements made by the representatives at this meeting of the Council, 1. To take note of the establishment. of the I!nter-American Emergency Aid Fund and of its Statutes. 2. To thank the Secretary General of the Organization of American States for promptly making available the necessary funds for carrying out the purposes of the Inter-American Emergency Aid Fund. 3. To thank the Governments that have provided Honduras and El Salvador, either through PAHO or on their own account, with effective assistance in the form of manpower or material resources for improving health conditions in the areas affected by the emergency. 4. To express its satisfaction with the action taken by the Director of the Pan American Sanitary Bureau, and to authorize him, in accordance with Article 6.5 of the PAHO Financial Regulations, to make an advance of up to $100,000 from the Working Capital Fund for the purpose 'of providing Honduras and El Salvador with assistance if the urgency of the situation so requires. (Approved at the tenth plenary.session, 3 October 1969) Resolution XII Laboratory Colonies of Aedes aegypti' 3 Bearing in mind that the XVII Pan American Sanitary Conference in 1 2 Mimeographed document. 1 3 For reference Document CD19/7, see Official Document PAHO

18 Resolution XX'4 established that in order for a country to be declared by the Governing Bodies of the Pan American Health Organization to be free of Aedes aegypti it must not permit the existence of any colony of the mosquito in its territory except in areas ecologically unfavorable to the vector and subject to conditions making it impossible for the country to be reinfested by A. aegypti from those colonies; Considering that in the same resolution the Conference recommended to the Director of the Pan American Sanitary Bureau that he convene a group of experts to establish the conditions which colonies of the mosquito must satisfy if their presence in the ecologically unfavorable areas of a country is not to prevent that country from being considered free of A. aegypti; Bearing in mind that pursuant to this recommendation the Bureau sponsored the meeting of a Working Group on Laboratory Colonies of Aedes aegypti at PAHO Headquarters in Washington, D. C., from 17 to 19 July 1967; Having examined the report' s prepared by the afore-mentioned Working Group, containing detailed conditions goveming the establishment and operation of colonies of A. aegypti and specifying the security and surveillance measures required to avoid reinfestation from those colonies; and Considering that the conditions and measures in question are adequate for the purpose intended, 1. To reiterate that, in addition to the eradication requirements established by the Pan American Sanitary Bureau and included in the Guide for the Reports on the Aedes aegypti Eradication Campaign in the Americas, 16 in order to be considered by the PAHO Governing Bodies to be free of the vector a country must satisfy the following conditions: a) To eliminate all colonies of A. aegypti that exist in areas in their territory in which the ecological conditions are favorable to the development of the vector. b) Not to permit the existence of any colony of the mosquito except in recognized research centers situated in areas that are ecologically unfavorable to the vector; c) To ensure that colonies of the vector existing in those unfavorable areas are permanently maintained in such a way as not to allow the country to be reinfested by A. aegypti from those colonies. 2. To approve the conditions and security measures recommended by the Working Group on Laboratory Colonies of Aedes aegypti for the establishment. operation, and inspection of colonies of the mosquito. 1 40fficial Document PAHO 74, Official Document PAHO 84, ' 6 Miscellaneous Publication PAHO 49 (1960). 62

19 3. To adopt those standards and security measures which colonies of A. aegypti must satisfy if their presence in ecologically unfavorable areas of a country is not to prevent that country from being declared free of the vector by the Governing Bodies of the Pan American Health Organization. 4. To recommend to interested Governments that they prepare and promulgate as rapidly as possible the regulations needed to ensure that such colonies of A. aegypti as Governments may decide to allow in their particular countries comply with the above-mentioned conditions and security measures. (Approved at the tenth plenary session, 3 October 1969) Resolution XIII Provisional Draft of the Proposed Program and Budget Estimates of the Pan American Health Organization for 1971 Having studied in detail Official Document 92, submitted by the Director of the Pan American Sanitary Bureau, which contains the provisional draft that is to constitute the basis for the preparation of the Proposed Program and Budget Estimates for the Pan American Health Organization for 1971 to be considered by the 64th Meeting of the Executive Committee and by the XVIII Pan American Sanitary Conference; and Recognizing that the provisional draft of the Proposed Program and Budget Estimates contains soundly conceived and much-needed health projects, 1. To take note of the provisional draft of the Proposed Program and Budget Estimates of the Pan American Health Organization for 1971, appearing in Official Document To request the Director to use the provisional draft as a basis for the preparation of the Proposed Program and Budget Estimates for 1971, after further consultations with Governments to determine their latest desires and requirements in relation to the priorities of the Organization. 3. To request the Executive Committee to make a detailed examination of the revised Proposed Program and Budget Estimates for 1971 to be presented by the Director, after further consultations with Governments, and to submit its recommendations thereon to the XVIII Pan American Sanitary Conference. (Approved at the thirteenth plenary session, 6 October 1969) 63

20 Resolution XIV Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for 1971 Having studied in detail Official Document 92, submitted by the Director of the Pan American Sanitary Bureau, which contains the Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for 1971; Bearing in mind that the aforesaid Proposed Program and Budget Estimates are submitted to the Directing Council, Regional Committee of the World Health Organization, for review and transmittal to the Director-General of the Organization so that he may take them into account in preparing the budget estimates of WHO for 1971; and Noting the recommendations' 7 made by the Executive Committee at its 62nd Meeting, 1. To approve the Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for. 1971, appearing in Official Document 92, and to request the Regional Director to transmit them to the Director-General of the Organization so that he may take them into account in preparing the WHO budget estimates for To request the Regional Director to transmit to the Director-General a request that he maintain the level of the WHO budgetary appropriation for malaria eradication in the Americas by increasing the appropriate allotment in the WHO regular budget to the extent necessary to offset any reduction in the allotment from the WHO Malaria Eradication Special Account. (Approved at the thirteenth plenary session, 6 October 1969) Resolution XV Election of Three Member Governments to the Executive Committee on the Termination of the Periods of Office of Brazil, Colombia, and the United States of America The Directing Councu, Considering the provisions of Article 9-B of the Constitution of the Pan American Health Organization; and 17 Resolution 1. Docunient CE62/6. 64

21 Considering that the Governments of Guyana, Peru, and Venezuela were elected to the Executive Committee on the termination of the periods of office of Brazil, Colombia, and the United States of America, 1. To declare the Governments of Guyana, Peru, and Venezuela elected to the Executive Cornmittee for a period of three years. 2. To thank the Governments of Brazil, Colombia, and the United States of America for the services rendered to the Organization by their representatives on the Executive Committee. (Approved at the thirteenth plenary session, 6 October 1969) Resolution XVI Assessments of the Member Governments and Participating Governments of the Pan American Health Organization Taking into account that Member Governments appearing in the scale adopted by the Council of the Organization of American States are assessed according to the percentages shown in that scale, in compliance with Article 60 of the Pan American Sanitary Code; and Considering that other Member Governments and Participating Governments are assessed in accordance with Resolutions XXVII and XXVIII 8 of the XVII Meeting of the Directing Council, To establish the assessments of the Member Govemments and Participating Governments of the Pan American Health Organization for 1970 in accordance with the scale of quotas shown below and in the corresponding amounts. '80fficial Document PAHO 82, (See following page) (Approved at the fourteenth plenary session, 8 October 1969) 65

22 (I) (2) (3) Gross OAS scale assessment Country % US$ Argentina 7.18 Barbados 0.08 Bolivia 0.31 Brazil 6.87 Chile 1.77 Colombia 1.54 Costa Rica 0.31 Cuba 1.46 Dominican Republic 0.31 Ecuador 0.31 El Salvador 0.31 Guatemala 0.39 Haiti 0.31 Honduras 0.31 Mexico 6.71 Nicaragua 0.31 Panama 0.31 Paraguay 0.31 Peru 0.77 Trinidad and Tobago 0.31 United States of America Uruguay 0.69 Venezuela 3.13 Subtotal Equivalent percentages Other Member Governments Guyana 0.21 Jamaica 0.31 Participating Governments France 0.22 Kingdom of the Netherlands 0.19 United Kingdom 0.26 Subtotal Total Assessments- All Countries 1,083,534 12,072 46,782 1,036, , ,402 46, ,329 46,782 46,782 46,782 58,855 46,782 46,782 1,012,606 46,782 46,782 46, ,202 46,782 9,960, , , ,995 31,691 46,782 33,200 28,673 39, ,583 (4) Credit from tax equalization fund US$ 115,193 1,283 4, ,219 28,397 24,707 4,974 23,424 4,974 4,974 4,974 6,257 4,974 4, ,652 4,974 4,974 4,974 12,354 4,974 1,058,880 11,070 50,217 1,604,367 3,369 4,974 3,530 3,048 4, ,270,578 1,623,459 (5) Adj. for taxes by Govts. on emoluments of PAHO staff US$ , ,990 (6) Net assessment US$ 968,341 10,789 41, , , ,034 41, ,905 41,808 41,808 41,808 52,598 41,808 41, ,954 41,808 41,808 41, ,848 41,808 9,263,557 93, ,401 13,849,618 28,322 41,808 29,670 25,625 35, , ,990 14,010,109 (2) This column includes the OAS percentages adding to 100 per cent and the equivalent percentages applicable to other Member Governments and Participating Governments. The OAS scale minimum assessment is 0.31 per cent or per-capita contribution equal to that of the largest contributor, whichever is smaller. (5) This column includes estimated amounts to be received by the respective Member Governments in 1970 in respect of taxes levied by them on staff members' emoluments received from the PAHO, adjusted for any difference between estimate and actual for the second preceding year.

23 Resolution XVII Malaria Eradication Having considered the XVII Report of the Director of the Bureau on the status of malaria eradication in the Americas (Document CD 19/2);'9 Bearing in mind Resolution WHA of the Twenty-Second World Health Assembly on the revision of the strategy of malaria eradication; Cognizant of the progress made in 1968 in shifting new areas into the consolidation and maintenance phases and in protecting all the malarious areas for the first time, even though administrative and financial difficulties persist; Taking into account that there are areas with technical problems the extent and origin of which are in large measure known, and that investigations have shown that there are effective methods for solving some of these problems; Aware of the importance of the work of the general health services, especially in areas in the maintenance and consolidation phases; Considering that some countries have or are preparing over-all economic development plans that provide for activities in malarious areas; Bearing in mind that, if malaria eradication programs are to be given appropriate priority in the assignment of funds, their economic value must be demonstrated; and Considering that the Governments have received valuable assistance from some international agencies, 1. To take note of the XVII Report on the status of malaria eradication in the Americas (Document CD 19/2). 2. To request the Director to assist the Director-General of the World Health Organization in applying the new world-wide strategy for malaria eradication. 3. To express to the Governments its satisfaction with the progress made by the malaria eradication program and to urge them to continue to take the necessary steps to ensure that these programs are properly financed and efficiently administered and that the most effective methods are promptly used. 4. To recommend to the Governments and to international agencies that they continue to undertake and encourage research designed to identify, study, and solve present and potential technical problems. 5. To request the Governments to strengthen the coordination of the malaria eradication services and general health services and to ensure that the 1 9 See Official Document PAHO Off Rec. Wld Hlth Org. 176,

24 transfer to the general health services of the responsibility for malaria surveillance activities is carefully planned so as to avoid unfavorable repercussions. 6. To remind the Governments of the importance of malaria eradication programs, as part of the health sector, in the over-all economic development plan and to request them, as well as international agencies, to continue research on the economic and social effects of malaria and malaria eradication. 7. To thank PASB, WHO, UNICEF, and the United States Agency for International Development for their assistance to the Governments in their 1968 campaigns. 8. To express at the same time its concern over the tendency of voluntary cooperation, and the cooperation of some international agencies in financing malaria eradication program activities, to decline, and to request the authorities concerned to reconsider their policy of regional and world collaboration for this program. (Approved at the fifteenth plenary session, 8 October 1969) Resolution XVIII Report of the Study Group on the Coordination of Medical Care Services of Ministries of Health, Social Security Institutes, and Universities Having examined the report of the Director of the Pan American Sanitary Bureau (Document CD19/19, Rev. 1)21 apprising the Directing Council of the final report of the Study Group on the Coordination of Medical Care Services of Ministries of Health, Social Security Institutes, and Universities, jointly convened by the Organization of American States and the Pan American Health Organization, which met in Washington, D. C., from 4 to 8 August 1969, 1. To thank the members of the Study Group for their work. 2. To thank the Organization of American States for its assistance in organizing the meeting. 3. To confirm the recommendations of the Study Group. 4. To recommend to the Director that he give the report the widest possible 2 1 See Official Document PAHO

25 circulation so that the health authorities of the countries of the Americas may take it into account in organizing their national health services. 5. To recommend to the Director that he organize zone meetings of senior health, social security, and medical education officials for the purpose of discussing how and to what extent the recommendations of the Study Group can be applied in the countries concerned. (Approved at the fifteenth plenary session, 8 October 1969) Resolution XIX PAHO Regional Library of Medicine Having considered the report on the status of the PAHO Regional Library of Medicine (Document CD19/8), 22 and the report of the second meeting of its Scientific Advisory Committee (Document RD8/16); 2 3 Having noted the rapid progress made by the Regional Library in the first eight months of its regional services to Brazil; Noting with concern that the demand for the Library's services is already such that it is becoming difficult to satisfy it efficiently; and Considering that there are bibliographic centers and libraries in the Mejnber Countries of the Organization that could be used for a program of this kind, 1. To congratulate the Director and his staff on the progress attained, which has enabled the Regional Library of Medicine to become an active center for biomedical communications. 2. To thank the Government of Brazil, the United States National Library of Medicine, the Commonwealth Fund, and the Pan American Federation of Associations of Medical Schools for the excellent cooperation they have extended to the Regional Library. 3. To instruct the Director to give the highest priority in the further development of the Regional Library to planning its activities, establishing a sound internal organization staffed by a sufficient number of well-trained personnel, and improving the basic collection, in accordance with recommen- 22 See Official Document PAHO Mimeographed document. 69

26 dations of the Scientific Advisory Committee of the Library (Document RD8/16). 4. To instruct the Director to submit each year to the Executive Committee the program and budget of the Regional Library for the following year. 5. To instruct the Director to explore all possibilities of supplementing the financing of the Regional Library with international, national, and private funds, and to make a study of partial self-financing based on specific payment by the countries for the use of certain services offered by the Library. 6. To emphasize the need to begin the program for training the staff in modern procedures for the collection, classification, and use of bibliographic information in the biomedical sciences, for which provision is made in the plans of the Regional Library of Medicine. 7. To recommend to the Director that he study the possibility of increasing the resources of the Regional Library by incorporating into the program other bibliographic centers and libraries in other Member Countries of the Organization. (Approved at the sixteenth plenary session, 9 October 1969) Resolution XX Brazilian Plan for the Coordination of Activities Relating to the Protection and Recovery of Health Considering the presentation made by the Representative of Brazil on the Plan for the Coordination of Activities Relating to the Protection and Recovery of Health (Document CD19/26, Annex), 2 4 which is being put into effect in that country; Bearing in mind that, in its general lines, this plan follows the ideas embodied in Resolution XX 2 5 of the XVII Meeting of the Directing Council of the Organization and the recommendations in Section VIII 2 6 of the Final Report of the Special Meeting of Ministers of Health of the Americas, held in Buenos Aires, Argentina, in October 1968; and Considering that the Plan provides administrative machinery which is a new experiment for the country in the health field and is worthv of study, 2 4 Mimeographed document. 2 5 Official Document PAHO 82, Official Document PAHO 89,

27 To take note of the Brazilian Plan for the Coordination of Activities Relating to the Protection and Recovery of Health and of the steps taken to put it into practice, and to thank the Brazilian Government for the paper on the subject presented at this meeting of the Directing Council. (Approved at the sixteenth plenary session, 9 October 1969) Resolution XXI Amendments to the Staff Rules of the Pan American Sanitary Bureau Bearing in mind the provisions of Staff Regulation 12.2, To take note of the amendments 2 7 to the Staff Rules of the Pan American Sanitary Bureau presented by the Director in the Annex to Document CE61/8 and approved 2 8 by the Executive Committee at its 61st Meeting with the effective date 1 January (Approved at the sixteenth plenary session, 9 October 1969) Resolution XXII Salary of the Director of the Pan American Sanitary Bureau Considering the revisions that were made as from 1 January 1969 in the salary scales for internationally recruited staff in graded posts; 2 7 Rules 230.4, 235.1, 255.1, 255.2, 455, 455.2, 730.3, 830.4, Resolution XVI. Official Document PAHO 96,

28 Having noted the action taken by the Executive Committee 2 9 at its 61st Meeting to establish the annual salary of the Deputy Director and the Assistant Director; and Bearing in mind the importance of the Pan American Health Organization as the specialized agency for health in the Organization of American States system, and the weight of the executive and technical responsibility involved in the direction of PAHO/WHO activities in the Americas, To establish the net salary of the Director of the Pan American Sanitary Bureau at the level of $25,225 per annum, with effect from 1 January (Approved at the sixteenth plenary session, 9 October 1969) Resolution XXIII Aedes aegypti 3 O Recognizing that the prevention or control of urban yellow fever, dengue, and other diseases transmitted by Aedes aegypti is of serious concern to all Member Countries of the Organization; Noting the successes in some of the Member Countries in the programs to eradicate A. aegypti, but fully cognizant of the continuing problem of reinfestation in areas that had been cleared; Considering that the hemispheric campaign to eradicate A. aegypti has :in the last few years encountered serious obstacles; and Recognizing that control of diseases transmitted by A. aegypti must be a hemisphere-wide coordinated program, 1. To request the Directorto sponsor an in-depth study of the strategy and methods of preventing the diseases transmitted by A. aegypti, and to this end: a) Name, as quickly as possible, while continuing assistance to ongoing programs, a multidisciplinary group to review the present strategy for the prevention and control of diseases transmitted by A. aegypti in the Americas 2 9 Resolution XVII. Official Document PAHO 96, For reference Document CD19/7, see Official Document PAHO

29 and, as necessary, to define the objectives and guidelines of a study that would examine all possible alternative systems, including the public health and economic consequences of the different systems. b) Engage an independent agency to carry out as necessary the study defined by the multidisciplinary group and provide that agency with all assistance needed to obtain the facts, and professional technical advice required, presenting an assessment of the various alternatives-the relevancy of which should be based upon a cost/benefit analysis. c) Present the results of these studies to the XVIII Pan American Sanitary Conference with an interim progress report to the 64th Meeting of the Executive Committee. 2. To request the Director to seek through voluntary contributions the funds to cover the costs of this study. 3. To recommend to Governments that, independently of the results of this study, they continue to give all possible support to programs of A. aegypti eradication and take appropriate measures to safeguard the gains already obtained. (Approved at the seventeenth plenary session, 9 October 1969) Resolution XXIV Fluoridation of public water supplies Having considered the report on the fluoridation of public water supplies (Document CD19/21), 3 1 submitted by the Director in accordance with Resolution X 32 of the 61st Meeting of the Executive Committee; Considering that dental caries is an important health problem in all Member Countries; and Considering that the Twenty-Second World Health Assembly made a thorough analysis of this problem and recommended 3 3 to the Member States that they examine the possibility of introducing the fluoridation of public water supplies where the fluoride intake from such sources is below optimum levels, 1. To take note of the report of the Director on the present status of 3 1 See Official Document PAHO fficial Document PAHO 96, Resolution WHA Off.Rec. Wld Hlth Org. 176,

30 fluoridation of public water supplies, including financing, in the various countries. 2. To take note of the recommendations of the Twenty-Second World Health Assembly on the fluoridation of public water supplies. 3. To urge the national water authorities to take the necessary measures to introduce fluoridation of public water supply systems where the fluoride intake from such sources is below optimum levels. 4. To recommend to the Director that he continue to promote the fluoridation program and, in particular, to the training of personnel in this field. (Approved at the seventeenth plenary session, 9 October 1969) Resolution XXV Study of the Preparation of Drugs and Biological Products, Production and Maintenance of Equipment and Instruments for Health Programs Having examined Resolution VIII 3 4 adopted by the Executive Committee at its 61st Meeting; Bearing in mind the report by the Director of the Bureau (Document CD19/21) 3 5 on the study of the production of drugs and the manufacture and maintenance of equipment and instruments for health programs; and Considering also Resolution XII1 3 6 of the XVI Meeting of the Directing Council, according to which Recommendations VII.C.1 and C of the Task Force on Health at the Ministerial Level (Washington, D. C., April 1963) were made part of the policy of the Organization, To recommend to the Director that he request the Governments to consider the possibility of having such studies carried out in their particular countries, 34 Official Document PAHO 96, See Official Document PAHO Official Document PAHO 66, Official Document PAHO 51,